Purpose: To evaluate the diagnostic capability of the MR-urography with low-dose diuretic injection in the evaluation of urinary tract obstruction. Methods and Materials: 55 patients suffering symptoms by obstructive uropathy underwent MR examination, using a total body MR system (1.5T Philips Intera and GE Horizon), heavily T2-w sequences with fat suppression and MIP post-processing. To obtain a useful repletion of the urinary tract, diuresis was induced by i.v. administration of saline solution (NaCl 9%, 250 ml) and furosemide (0.1 mg/Kg); the MR acquisition was obtained about ten minutes after diuresis induction. Standard MRI was also performed. 50 patients were submitted to excretory urography; 21 patients were submitted to CT examination. Results: The site of the obstruction was recognised in all cases. The cause of the obstruction was recognised by standard MR examination and the other imaging techniques, by clinical history and urinary cytology and biopsy. 15 patients had urinary tract obstruction by urinary stones, 11 intrinsic neoplasm (8 bladder, 3 ureter), 18 by extrinsic neoplasm, 4 by uretero-pelvic junction benign stricture, 6 congenital ureteral stricture, 1 was iatrogenic. Conclusion: Our experience confirms T2-w MR urograms to be excellent in the visualisation of the dilated urinary tract, also when the renal excretory function is quiescent. MR urography can replace conventional excretory urography when it is contraindicated or undesirable. MR urography performed in combination with standard MR imaging can reduce the need for invasive retrograde pyelography.

MR urography after low-dose diuretic injection in the evaluation of urinary tract obstruction

VICENTINI, Carlo;DI CESARE, Ernesto;MASCIOCCHI, CARLO
2003

Abstract

Purpose: To evaluate the diagnostic capability of the MR-urography with low-dose diuretic injection in the evaluation of urinary tract obstruction. Methods and Materials: 55 patients suffering symptoms by obstructive uropathy underwent MR examination, using a total body MR system (1.5T Philips Intera and GE Horizon), heavily T2-w sequences with fat suppression and MIP post-processing. To obtain a useful repletion of the urinary tract, diuresis was induced by i.v. administration of saline solution (NaCl 9%, 250 ml) and furosemide (0.1 mg/Kg); the MR acquisition was obtained about ten minutes after diuresis induction. Standard MRI was also performed. 50 patients were submitted to excretory urography; 21 patients were submitted to CT examination. Results: The site of the obstruction was recognised in all cases. The cause of the obstruction was recognised by standard MR examination and the other imaging techniques, by clinical history and urinary cytology and biopsy. 15 patients had urinary tract obstruction by urinary stones, 11 intrinsic neoplasm (8 bladder, 3 ureter), 18 by extrinsic neoplasm, 4 by uretero-pelvic junction benign stricture, 6 congenital ureteral stricture, 1 was iatrogenic. Conclusion: Our experience confirms T2-w MR urograms to be excellent in the visualisation of the dilated urinary tract, also when the renal excretory function is quiescent. MR urography can replace conventional excretory urography when it is contraindicated or undesirable. MR urography performed in combination with standard MR imaging can reduce the need for invasive retrograde pyelography.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11697/24613
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